Is Your Diet Affecting Your Psoriasis?

While you may be reluctant to accept that your dietary habits play a great role in your psoriasis, a number of studies have shown that changes in dietary habits and practices have beneficial effects on the condition. There are even reports that record accounts of improvement in psoriasis in wartime when food supply was not sufficient to camp prisoners.

If you have noticed, the prevalence of psoriasis is not usually common among Africans. Genetics may be an influencing factor here, but it can also be shown that Africans (except those who have adopted a Western lifestyle) usually consume lower polyunsaturated fatty acids and higher in linoleic acid. The Inuits of the Arctic regions and the Sami peoples of northern Europe have a low prevalence of the disease. These two indigenous groups consume fish oils (omega-3 fatty acids) which help improve psoriasis and a number of other inflammatory diseases.

Weight gain has also been reported to be coupled with the worsening of psoriatic lesions. While you may still be unconvinced that your diet has a direct link to your psoriasis, you cannot avoid the fact that psoriasis is an auto-immune disorder and a number of debilitating diseases have already been linked to psoriasis. Hence, it is only prudent for psoriatic sufferers to maintain a healthy diet in order to manage this chronic condition and to avoid other complications.

While there is no specific diet that can treat your psoriasis, you may want to try out these dietary guidelines:

• Consume a wide variety and plenty of fresh vegetables and fruits. Raw vegetables (as long as they are clean) are better than cooked ones.
• Choose lean meats, if you're a meat lover.
• Eat fishes high in omega-3 fatty acids, such as sardines, mackerel, and salmon.
• Keep hydrated by drinking plenty of water.
• Avoid, or at least, minimize your consumption of alcohol, caffeine, and processed foods.

These are simple, down-to-earth guidelines, yet following them can contribute significantly to your good health and, by consequence, to better skin condition. There is a good number of people who strongly believe that certain types of food will worsen the condition of their skin. If you agree with this idea and you are able to identify which types do damage to your skin, you should seriously consider reducing your intake of these foods or doing away with them altogether.

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How to Care for Psoriasis Patients

If a member of your family or one of your friends has psoriasis, then you must have seen the effect of the disease on the sufferer's quality of life. Psoriasis affects not only the persons with the diagnosis, but also the people around them. It is even more painful to see your loved-one slowly avoiding his or her friends and choosing to live in isolation because of the condition.

Below are some of the things that you can do to help your friend or loved-one cope with disease.

• Understand the condition. The first thing that you can do is to understand psoriasis. With the advent of the internet, it is now much easier to find information about the condition. Make sure that you have a good idea on how a person acquires the disease, its symptoms and the available psoriasis treatments whether conventional or natural treatments.

• Minimize stress in your surroundings. It has already been established that stress triggers the flare-ups of the disease. While it is not possible to completely eradicate stress in the households these days, you can help reduce it. You can ask your loved-one the things that might lessen his or her stress. It might help if you offer to do on some days the chores that the patient usually does. Or, if he or she is not keen to unload the chore, you can ask to swap some heavier duties with a lighter one. Avoid being pushy, however, as it may upset your loved-one. Sympathize, if you wish, but do not patronize.

• Ask, don't assume. While your intention of helping your loved-one is good, it is always better to ask his or her needs. Do not try to make assumptions, because what you think might not be what your loved-one wants or needs. Will it be okay to go to the doctor's office with him or her? Does he or she want his or her friends to visit in the house?

• Know your own limits. Your loved-one may need all the support he or she can get from his or her family because of the condition. It does not mean, however, that you have to own up all the responsibilities for your loved-one, especially when the latter is already an adult. Your role is to help him or her take care of himself or herself. It is never to make him or her dependent on you.

• Make sure you look out for yourself, too. It's not only psoriasis sufferers who become emotionally drained when battling with the condition. Caregivers can feel the same way, too. Hence, you must not forget to take care of yourself and live your own life. Do things that you want to do and give yourself a break sometimes. You would not want to end up worn out with the experience.

How to Choose the Right Psoriasis Doctor

If you have been led to this site by googling the keywords "psoriasis doctors Philippines," then I hope that this article will be of help in your search for the right healthcare professional. Keep in mind that having psoriasis only means that your relationship with your psoriasis doctor is a long-term one. Hence, you would want to work with the right doctor in treating and/or managing your psoriasis.

The Doctor's Field of Specialization
Since psoriasis affects the skin, the first thing that should come to mind is a doctor specializing in skin disorders and their treatments, called a dermatologist. If you don't know any dermatologist in your area, then the Philippine Dermatological Society (PDS) website is a good starting point.

Look for the words Find A Derm on the upper right corner of the PDS website's main page, then click it. You will be brought to the Doctor Locator page. There's a box which allows you to search a dermatologist using a map, or search by name, province, region, city/municipality and address. Regardless of the method you use in searching for a dermatologist in your area, the names, clinic location, and telephone numbers of the members of the PDS will appear on your monitor.

The Doctor's Background and Training
Not all dermatologists are alike, however. While you may be familiar, or want to consult, with the dermatologists whom you always see on television because they are the doctors of your favorite celebrity, they may not be trained for psoriasis treatment. Their training may be more in cosmetic dermatology.

Your best bet would be a doctor whose practice focuses on medical dermatology or immunodermatology. In order not to waste your time in going to the doctor, you may want to call the dermatologists first and inquire whether they are experienced in treating psoriasis. If you know any persons with psoriasis, then you can ask recommendations from them. You may also want to contact Psoriasis Philippines, or ask any of its members, for any dermatologists that they can recommend to you.

If you really want a doctor who thoroughly understands the disease, then a dermatologist who has a fellowship or membership with the National Psoriasis Foundation can be one of the requirements in your choice. These doctors have undergone special and/or extensive training in psoriasis treatment in the United States.

Sympathetic or Empathetic Doctors?
While you want a highly-trained doctor in treating your psoriasis, you would also want a doctor who treats you as a human being. Psoriasis highly affects our self-esteem and self-confidence, and you would only want a doctor who not only sympathizes but also empathizes with you.

You don't need more sympathy, that is, you don't want your doctor to share your suffering. He or she may not be able to help you that way. What you need from your doctor is a humane understanding of what you're going through. Theodore Lipps, the 19th century German psychologist, called it "einfuhlung" (which directly translates into "in-feeling"), which means that a health care professional should thoroughly understand your inner feelings and experiences as a patient and must be able to express that understanding to you.

Studies have shown that doctors who are empathetic are able to strengthen the relationship of trust with their patients. You may later find that this empathetic communication between you and the doctor makes it easier for you to accept the reality of your chronic condition. With acceptance comes the quiet resolve to do something about it. Then, it becomes easier to follow the prescribed treatment program and to proactively manage your psoriasis.

If the first doctor you visit does not have this vital attribute of empathy, try looking around. There must be someone out there: Filipino doctors are much sought after in other countries, not least because they are able to establish empathy with their patients.

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Will My Heart Go On Even If I Have Psoriasis?

The title of this entry must have made you think about the worldwide hit song of Celine Dion "My Heart Will Go On" from the movie Titanic. This post is neither about the movie nor the song. It has something to do with the link between psoriasis and heart disease. Is that news to you?

A number of studies in the last decade have already shown that psoriasis patients are also found to have or to develop cardiovascular diseases, such as high blood pressure or hypertension, high blood cholesterol level, heart failure, atherosclerosis and diastolic dysfunction. One of the theories postulated is that heart disease like atherosclerosis and psoriasis are both inflammatory conditions. The degree of inflammation in skins with psoriasis can be on a titanic scale, as in severe cases which cover the whole body of the patient.

In a 2005 study at Karolinska Institute in Sweden, it was shown that the risk of dying of heart disease for people in the 40-59 age group is 91 percent higher for those with severe psoriasis. For people over 60 with severe psoriasis, the risk is 37 percent greater. Those with mild to moderate psoriasis cases like me should not be complacent because the chance of developing any of the cardiovascular diseases is still there.

Researchers recommend that psoriasis patients must adopt a healthy lifestyle, including a healthy diet. The probability of developing cardiovascular disease is substantially minimized when a psoriasis patient practices healthy living.

On the personal note, I remember in early to middle 2008 when I noticed that something was no longer right with my body although my psoriasis at the time was still manageable. During the first half of that year, I put on an additional 20 pounds to my weight at end-2007. I thought that maybe the reason for my weight gain was due to hypothyroidism which can also be seen in some psoriasis patients. And so I went to see a doctor specializing in internal medicine.

After undergoing a series of blood testing, it was found out that I only had the so-called subclinical hypothyroidism. There were other conditions that were diagnosed, however. These were cardiovascular-related diseases — high blood pressure (which soared as high as 140/100 at some point) and also high blood cholesterol level. I vowed to correct these risk factors — and finally got rid of them in a matter of 90 days after the diagnosis. I was also able to shed 40 pounds. From that time up to now, I have maintained my ideal weight. I still want my heart to go on and function well despite my psoriasis.

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Moisturize, Moisturize, Moisturize: Psoriasis' First Line of Treatment

Psoriasis, which presents itself as dry skin mottled with red patches covered with off-white scales, is a condition that does not have any cure yet. That's the saddest thing about having, and the most common reason why we become frustrated over time when dealing with, this condition. Treatment for psoriasis varies differently among patients, but there is only one common goal: to rid our skin of the psoriasis lesions.

Often, doctors begin psoriasis treatment with a therapy which does not expose us to many side effects. If our response to the treatment using the least potent therapy is not promising, that's the time when doctors move up the scale, hoping to find the therapy that will clear the lesions. No matter what type of treatment (topical, light, systemic, or biologic) we use, we should not forget to moisturize our skin, including the lesions.

Aim of Emollient Therapy
While emollient therapy, or the use of moisturizers, does not make our psoriasis go away, it is an essential component in psoriasis care. Because it moisturizes and lubricates the skin, as well as helps remove scales from the psoriasis-affected patches, overall skin condition is enhanced. It is very useful in preparing our skin for application of active topical (e.g. creams or ointments containing steroids) or light therapies (natural sunlight, or UVB). Once the psoriatic skin is moisturized regularly, we feel more comfortable as we go about our everyday life because skin becomes less itchy, inflamed and scaly.

How to Apply Moisturizer on Skin
Moisturizers may come in the form of soap substitutes, lotions, steroid-free creams or ointments, and oil. Make sure you use the moisturizer that you are most comfortable with and have no qualms about using regularly, day in day out. Moisturizing the skin starts not after but during the bath or shower itself. If you are taking a shower, it is best to use a soap substitute (e.g. Cetaphil) to avoid drying the skin. For those who prefer using the bath tub, it helps to put some bath oil in the water; a thin film of oil will deposit on your skin, keeping moisture in.

Once you finish bath or shower, you can proceed to apply the lotion, or the steroid-free cream/ointment. You would not want to develop an infection on your hair follicles (called folliculitis), hence, make sure that in applying moisturizer you use long strokes in line with the natural direction of the hair. Avoid rubbing in too aggressive a fashion, as the friction provokes more plaque-formation. Instead, use a gentle, circular motion to work the liquid into the skin.

While it is best to apply moisturizers as often as possible during the day, it may not be practical in your work and lifestyle. You may want to make it a routine to apply the moisturizer before you go to work and then apply again before you sleep. Any application in between should be a great plus.

One final point about moisturizers: actually, they don't add water to your skin; instead, they minimize the amount of water lost via evaporation. If there is little water in your skin in the first place, then moisturizers will not help at all.

Make sure you do not become dehydrated by drinking plenty of fluids during the day. Then, moisturizers can do their job.

Photo credit: shawncampbell (flickr.com)

Resources:
Hughes, E. and Van Onselen, J. (2000). Dermatology Nursing. (New York: Churchill Livingstone).

Mitchell, T. and Penzer, R. (2005). Psoriasis At Your Fingertips Guide. (London: Class Publishing).

Rees, A. (1997). Consumer Health USA. (Phoenix: Oryx Press).

Suffering from Sore Throat? Guttate Psoriasis May Be Erupting Soon

If you have been suffering from sore throat recently, then watch out for any signs of psoriasis flare-ups in the next few weeks. Almost 80 percent of guttate psoriasis onset is triggered by streptococcal (or strep) bacteria, which causes sore throats.

Guttate Psoriasis' Clinical Apperance
In its clinical manifestation, guttate psoriasis may make you look like you had red polka dots of varying sizes all over your body. The Latin word, gutta, means ‘drop,’ hence, the description of droplike, or raindrop-like papules can often be found in books.

If you are more familiar with plaque psoriasis, you would most likely not recognize this condition as psoriasis from a distance. The red-colored spots may be mistaken for chicken pox, because the diameter of the lesions usually ranges between 0.1 and 1.0 centimeter. While the identifiable flakes are also present in guttate psoriasis, it is not as scaly as those in plaque psoriasis.

Guttate psoriasis is usually common among children and young adults. It could be the early manifestation of psoriasis or it could signify a looming acute flare-up of a pre-existing psoriatic condition, usually the plaque-type. If you have plaque psoriasis, then it is easier to diagnose guttate psoriasis. However, if it is the first time that this disease manifested, it may not be immediately diagnosed as psoriasis. Other conditions, such as pityriasis rosea and secondary syphilis, may be suspected. Family history and lab tests to confirm strep infection will be helpful in early diagnosis of guttate psoriasis.

Association of Strep Infection with Psoriasis
The immune system becomes overactive when there is streptococcal throat infection. It was in 1916 when Winfield made an observation that streptococcal infection is associated with psoriasis. The infection activates T-cells at various spots in the skin. These T-cells, which can penetrate into the skin, may mistakenly recognize certain foreign substances in the skin as part of the infection and proceed to attack them.

Some carbohydrates or keratins possess chemical identifiers similar to bacterial antigens. In a sense, the body is confused and over-reacts, believing the strep invasion is bigger than it actually is. As a result, some patients go on to develop the chronic condition of plaque psoriasis.

Guttate Psoriasis Treatment
In most cases, guttate psoriasis is resolved if the underlying infection is treated. It may take a few weeks, or months, for guttate psoriasis to be completely gone. In some patients, the condition does not recur. But in others, it temporarily worsens a preexisting psoriasis (which eventually recedes to its previous state) or it opens the possibility of minor recurrences of psoriasis.

To address strep infection, doctors often recommend a 10- to 14-day antibiotic therapy. Natural sunlight or ultraviolet B therapy may also be prescribed if there is no improvement after a month since the outbreak of guttate psoriasis, or if you have preexisting plaque psoriasis. If the doctor does not prescribe antibiotics, you may want to make sure it is not needed — since you do have the strep infection — or ask for a second opinion.

Photo credit: Foxtongue (flickr.com)

Resources:

Bergstrom, K. and Kimball, A. (2005). 100 Questions & Answers about Psoriasis. (Sudbury, MA: Jones and Bartlett Publishers).

Bos, J. (2004). Skin Immune System, Third Ed. (Boca Raton: CRC Press).

Camisa, C. (2004). Handbook of Psoriasis, Second Ed. (Malden: Blackwell Publishing).

Accepting Life with Psoriasis

The thought of living with psoriasis for the rest of your life is not an easy thing to accept. Although we have witnessed medical advances in recent decades, we are still being told to face the fact that there is no available cure for psoriasis yet. The most we can do is to manage the symptoms and try the best we can to avoid the triggers that cause psoriasis flare-ups.

Psoriasis Causes
We often ask our dermatologists what things cause the disease, and sometimes, even the specialists do not know how to explain or would rather not go into those details. Others simply prescribe different medications, whether topical, oral, or biologics, to treat the disease. The truth really is that the main cause of psoriasis is, up to this date, still unknown.

Researchers currently believe this hereditary disease is mediated by a set of T-cells whose autoimmune profile is highly susceptible to certain triggers. Some factors that could provoke the adverse reactions include stress, both physical and emotional; particular skin injuries or traumas (associated with Koebner’s phenomenon); bacterial infections (which triggers guttate psoriasis); and, various drugs (such as beta-blockers and anti-malarial medications).

Social and Psychological Implications
We often find it difficult to make the necessary adjustments in our lives when we are told that we have psoriasis. The disease does not only affect our physical appearance, but it also gives discomforts due to its itchiness and pain. People who do not understand psoriasis often think that we have a contagious disease. Sometimes, we find ourselves discriminated against in public places. It leads us to isolate ourselves from the public because of embarrassment and the stigma brought about by the disease. Depression, which only aggravates the condition, can also be found in some psoriasis patients.

Unlike vitiligo (another skin disorder) which can be disguised by cosmetic concealment, we cannot hide our skin lesions using that method. (Paging cosmetic companies, can you please manufacture one for us?) Our choices of clothing are constrained. We may want to wear the latest fashion styles, but we are restricted by our disease. Indeed, psoriasis has brought a significant impact in our quality of life.

Basic Things We Can Do
Managing the disease is a challenging task for us. Accepting psoriasis as a part and parcel of our lives will surely divert our emotional energy from depressing thoughts to more productive activities; this acceptance should relieve us of unnecessary stress associated with the condition. While fear and ignorance about the disease is still common these days, we can choose to have a positive attitude despite living with psoriasis. At least, society no longer ostracizes people with psoriasis unlike in biblical times.

Photo credit: tomswift46 (flickr.com)

Resource:
Buxton, P. and Morris-Jones, R. (2007). ABC of Dermatology. (Chichester, UK: Wiley-Blackwell).

Got Plaque Psoriasis? Aloe Vera May Help

Do you have plaque psoriasis (psoriasis vulgaris)? Treating plaque psoriasis with a topical form of aloe vera tends to reduce flare-ups. This is according to a research report presented during the International Congress of Dermatology (ICD) held in Prague last May. When compared with patients who use topical steroid, those who underwent aloe vera treatment showed greater improvement of their plaque psoriasis after eight weeks.

How to Identify Plaque Psoriasis
Plaque psoriasis is easier to identify than the other manifestations of this condition. Raised lesions, made vivid by bright red inflammation, form on your skin. Eventually the dead skin cells bunch up into off-white scales covering the lesions. Psoriasis vulgaris, or plaque psoriasis, is commonly found on your scalp, elbows, knees and trunk.

As the inflammation spreads, plaques may spread over larger patches of skin and merge into one another. The lesions may also appear in mirror-like locations on opposite sides of your body. Psoriasis occurs anywhere on the body, but plaque lesions seem to have a special affinity for your scalp, knees and elbows.

If you want to see some photographs of plaque psoriasis, you may want to click on this link of PsoriasisInternational.org. (Warning: You might find some of the pictures gross!)

The Aloe Vera Effect
The latest study reported at the ICD was not the first of its kind. Another clinical study was conducted in 1998 which found that applying aloe vera cream on affected skin three times daily for at least 28 days helped to control the psoriasis inflammation. In certain cases, skin outbreaks did not recur for about one year.

It is of no surprise that studies have found aloe vera to be beneficial to psoriasis patients. Legend has it that Cleopatra and Nefertiti used aloe vera as part of their beauty treatment regimen. The moisturizing characteristic of aloe vera, in fact, is the attribute that has encouraged me to use aloe vera as part of my psoriasis treatment. That's why I was ecstatic when I read about this latest report from the ICD.

Instead of using aloe vera cream, I use aloe vera gel. I usually apply the aloe gel after shower. I have been practicing this ritual for about two months now. It has an amazing effect on my skin. I still use corticosteroid cream, of course, but I keep it to the minimum, say, twice a week application.

You may want to try applying aloe vera cream, or aloe vera gel, on the affected parts. It is believed that the moisturizing and anti-inflammatory characteristics of aloe vera improve plaque psoriasis. Aloe vera has always been considered an alternative treatment without the detrimental local and systemic effects associated with chronic use of topical steroids.

Photo credit: Biology Big Brother (flickr.com)

Resources:

Balch, P. (2002). Prescription for Herbal Healing. (New York: Avery).

LeVan, L. (1999). The Psoriasis Cure. (New York: Avery).

Stressed Out? Be Ready for Psoriasis Flare-Ups

Do you still remember the time when you first noticed that you had psoriasis flare-ups? Were you not living stressful days at that time? While there is still some controversy about the role that the stress of daily living contributes to the flare-up of psoriasis, most, if not all, of us (psoriasis patients) agree that whenever a series of stressful events occurs in our lives, or even a single but particularly intense event, we would notice our psoriasis start to flare-up.

A Vicious Cycle
If stress is not the primary trigger, it can surely get psoriasis in a much worse condition. There can be a vicious cycle when we have a flare-up. The mere fact that we have the condition can be the cause of our stress. Because we worry about our condition, it aggravates the flare-up, which again causes another bout of stress. If we do not do anything about it, the cycle keeps on repeating over and over again. To stop this vicious cycle, effective psoriasis treatment is very important.

Reducing the Levels of Stress
There are many ways of reducing the levels of stress. What applies to me may not necessarily be applicable in your situation, but we can surely find a common ground. Some of the strategies that are generally applicable to psoriasis patients include:

• Rest. No matter how busy we are in our daily lives, it is of utmost importance that we find time to rest to keep psoriasis under control. Rest may be in the form of having sufficient sleep, or asking someone else to apply those topical creams and ointments to our skin.

•Engaging in activities that make us feel good. These activities may include playing your favorite sport, having a relaxing massage, doing a sunbath, attending yoga and meditation classes, and sharing your experiences with a support group, such as the Psoriasis Philippines Online Support Group.

These are just some ways that help minimize the levels of stress. You may want to share what works on you, too.

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Welcome Morning Sun! Take My Psoriasis Away

The next time you are under the morning sun, take the opportunity to expose the part of your body which is affected with psoriasis. While you may find it embarrassing, keep in mind that sunshine has long been known to help improve psoriasis. You may even find that regular exposure to mild sunlight is better than following a systemic immunosuppressive drug regimen.

The UVB Factor
There are three components of natural sunlight: visible light, ultraviolet A (UVA), and ultraviolet B (UVB). If once in a while you get sunburn after a few hours of sun exposure, it is actually UVB which is causing that. And it is the same UVB which is very beneficial to us, psoriatic patients.

Doctors usually prescribe narrow-band UVB treatment, especially in the West where natural sunlight is not all-year round. It can be an effective treatment, albeit temporary. Others may have a longer period of remission, some may not. To prolong the remission, doctors recommend that you undergo UVB treatment regularly. If you can afford it, you may want to own a home UVB apparatus to avoid the hassles of going to the doctor over and over again.

The Cheap Alternative
But if you live in a country where the sun shines almost every day, then welcome the morning sun with a smile. Mild sunlight, usually between 7am to 9am, is the cheapest psoriasis treatment. Whenever I have a flare-up I usually expose my affected skin to the morning sun for about 10 to 30 minutes a day, and it would greatly improve my psoriasis. If you intend to follow this regimen, it is highly recommended that you consult a healthcare professional first. While sunlight has beneficial effects, it may not necessarily be applicable in your case.

Photo credit: kiri :D (flickr.com)

Resources:
Habermann, T. (2006). Mayo Clinic Internal Medicine Board Review. (Boca Raton: CRC Press).

Rees, A. (1997). Consumer Health USA. (Westport: Greenwood Publishing Group).